Tag Archives: radiotherapy

Cost of Treatment for Dupuytren Contracture

Posted on by

Cost of Dupuytren treatment dependent on many variables   

It is not possible to provide clear and meaningful Dupuytren treatment cost information for any one type of procedure.  Costs differ so greatly in various parts of the U.S, and the world for that matter, although this is less true outside the U.S. where regulated socialized medicine is practiced.

Any reported cost of medical or surgical Dupuytren treatment would have to be speculative based on insurance plan deductibles, rate discounts negotiated between insurance company and doctor providing care, discounts for rapid cash payments of outstanding balances, etc.  In addition, there is not much published information about costs for various Dupuytren contracture treatments because doctors are very hesitant to advertise their fees for service since it is there professional standard that this would make them appear less professional, or at least cast suspicion about their financial motivation for offering this type of care.

Dupuytren treatment cost for hand surgery is also variable based on the specific technique used, the type of anesthesia required, the severity of the contracture, the number of hands and fingers involved and the need for physical therapy after surgery.  Lastly, even the response to treatment provided influences the cost of Dupuytren treatment since sometimes multiple needle aponeurotomy procedures must be done to a single finger to reduce strength and integrity of the cords involved.

Cost of treatment for Dupuytren contracture; surgical release, needle aponeurotomy, Xiaflex enzyme injections

As a cost reference point, here are price ranges to compare total cost of treatment for Dupuytren contracture for the basic medical procedures currently available, per hand involvement:

Open hand (release) surgery  $10,000-$16,000

Radiotherapy                            $6,000-$10,000 – one report on the internet of a $20,000 RT

Needle aponeurotomy             $700-1,000 per finger –one report of $3,000 cost at Mayo Clinic

Xiaflex injection                        $7,000-9,000 per finger

Because of the high costs for many forms of Dupuytren care in the U.S., a new industry has emerged which has been called medical tourism or vacation medical care.  In this scenario a patient from a high-cost country will travel to a lower-cost country to receive medical care.  While in that country the patient will often arrive days or weeks before the surgery to have a vacation there.  After the surgery is done and no complications or adverse reactions are evident the patient will return home.

Some host countries have a large and thriving medical tourism industry based on low cost lodging, food and recreation opportunities, and subsequently can also offer lower prices for what is reported to be the same or better surgical repair of Dupuytren contracture at lower fees, such as
In U.S. dollars

France                                   $   770
Poland                                   $1500
Romania                               $   455
Singapore                             $1600
Tunisia                                   $ 980

Cost of treatment for Dupuytren contracture using Alternative Medicine

While the ultimate Alternative Medicine cost to treat Dupuytren contracture is also dependent on the same variables as medical care, the cost for four months of non-drug and non-surgical care with a DCI based medium treatment plan would be $520.  Bear in mind that this form of treatment does not have any side effects, will not result in more contracted tissue, nerve damage or ruptured tendons, presents no possibility for infections, and does not require physical therapy rehabilitation.

Cost is not the only factor, but satisfaction after treatment based on safety and reduced complications.  These last issues are very important to also consider when assessing the cost of treatment for Dupuytren treatment.

Getting Started with Dupuytren’s Contracture Treatment

>> Dupuytren Contracture Treatment – FAQs

>> Testimonials from Dupuytren Contracture Institute

 

Dupuytren Radiotherapy

Posted on by

Dupuytren treatment with radiation therapy for small hand nodules only

Dupuytren radiotherapy is the medical use of low-level x-ray radiation directed specifically at the involved hand lump and nodules, spread out over several sessions with a few month interval of non-treatment between each.   The effectiveness of Dupuytren radiation rests on its use as a preventative measure when used early in the disease process to prevent progression, not as an active treatment for later phase hand contracture.

Dupuytren radiotherapy is a fairly recent innovation for medical treatment of Dupuytren contracture before it evolves into finger contractures and limited hand usage; all other medical treatment is applied later in its progression.

According to the German medical clinics who are currently performing the bulk of these procedures, Dupuytren treatment with radiation therapy has a favorable outcome and is said to be able to stop the development of a tiny bump in palm either permanently or for a reasonable length of time; they report that occasionally the Dupuytren nodules disappear entirely if they are tiny when treated.  The significant drawback of Dupuytren radiotherapy is that once someone with Dupuytren contracture develops finger contracture or bending, this procedure is not able to produce any tissue changes.   It is not clear why clinics or universities in the U. S. are not performing Dupuytren radiotherapy.

Radiotherapy for Dupuytren contracture

Generally, radiation therapy (RT) is that branch of medical practice concerned with cancer treatment by means of high-energy beams of ionizing radiation directed at the intended diseased target tissue.  RT functions to server to control cancerous tumor growth while limiting and minimizing radiation exposure to the adjacent normal and healthy tissue.

The most common technique of radiation therapy for Dupuytren contracture is to deliver one radiotherapy series of five sessions performed five days in a row, in which five GY of radiation are delivered, followed by a pause in therapy that could be anywhere from six to 12 weeks, after which another radiotherapy series of five sessions performed five days in a row, in which five GY of radiation are again delivered.  Some medical clinics deliver 3 GY or 4 GY daily for a five day total series dose of 15 GY or 20 GY.

A GY (gray unit) is the international system (SI) unit of an ionizing radiation dose expressed in terms of absorbed energy per unit mass of tissue.   A gray (GY) is the unit that expresses the absorbed dose of radiation.  The GY has replaced the older term, rad. Now, one GY equals to one Joule/kilogram and also equals 100 rad.

Radiation therapists who perform this treatment justify its use in Dupuytren contracture explaining that radiation damages a special soft tissue cell, the fibroblast, which is an important cellular component for the progression of the disease.  Yet, this same group of doctors admits that it is very difficult to find scientific evidence to prove that radiation selectively destroys or alters fibroblasts.  They also admit radiation therapy is unproven for Dupuytren contracture since it is impossible to collect verifiable data about their controversial therapy because hand  nodules and cords are known to be dormant or stagnate for months or years at any time during the course of the disease, with or without Dupuytren treatment.

Interestingly, it is in the guidelines of the German Association for Hand Surgery (Germany is where most Dupuytren radiotherapy is performed) that call this use of RT in Dupuytren treatment as  obsolete and out of use.  Among the reasons for their position is the potential for negative unintended consequences of radiation therapy:

  • Radiation burn injury to the skin
  • Cumulative radiation exposure from and/or treatment either before or after Dupuytren RT may cause cancer
  • Unknown consequences of this procedure, such as interference with later surgery of the hand due to tissue weakness created by the RT for those who do not respond favorably
  • Very few clinics or facilities that perform this procedure have sufficient experience and knowledge or correct equipment, to perform Dupuytren radiotherapy –yet do so.

As a result of RT exposure those who conduct this procedure report a typical softening of the nodules or cords so treated that prevents later contraction of the hand.

A significant difficulty of Dupuytren radiotherapy is that few people consult a doctor in the very early stage of Dupuytrens when this method of treatment is primarily beneficial.  Dupuytren RT is not used after the hand nodules are larger than a few millimeters across.

If your Dupuytren contracture is advanced beyond the early stages, or you are not interested in using ionizing radiation as a treatment option, consider Alternative Medicine to reduce the density and contraction of your Dupuytren hand problem.